TY - JOUR T1 - Incidence of Cyclophosphamide-induced Urotoxicity and Protective Effect of Mesna in Rheumatic Diseases JF - The Journal of Rheumatology JO - J Rheumatol SP - 1661 LP - 1666 DO - 10.3899/jrheum.150065 VL - 42 IS - 9 AU - Neslihan Yilmaz AU - Hakan Emmungil AU - Sercan Gucenmez AU - Gulsen Ozen AU - Fatih Yildiz AU - Ayşe Balkarli AU - Gezmis Kimyon AU - Belkis Nihan Coskun AU - Ismail Dogan AU - Omer Nuri Pamuk AU - Sule Yasar AU - Gozde Yildirim Cetin AU - Ayten Yazici AU - Serpil Ergulu Esmen AU - Yonca Cagatay AU - Sema Yilmaz AU - Ayse Cefle AU - Mehmet Sayarlioglu AU - Timucin Kasifoglu AU - Omer Karadag AU - Yavuz Pehlivan AU - Ediz Dalkilic AU - Bunyamin Kisacik AU - Veli Cobankara AU - Eren Erken AU - Haner Direskeneli AU - Kenan Aksu AU - Sule Yavuz Y1 - 2015/09/01 UR - http://www.jrheum.org/content/42/9/1661.abstract N2 - Objective. To assess bladder toxicity of cyclophosphamide (CYC) and uroprotective effect of mesna in rheumatic diseases.Methods. Data of 1018 patients (725 women/293 men) treated with CYC were evaluated in this retrospective study. All of the following information was obtained: the cumulative CYC dose, route of CYC administration, duration of therapy, concomitant mesna usage, and hemorrhagic cystitis. Cox proportional hazard model was used for statistics.Results. We identified 17 patients (1.67%) with hemorrhagic cystitis and 2 patients (0.19%) with bladder cancer in 4224 patient-years. The median time for diagnosis to hemorrhagic cystitis was 10 months (4–48) and bladder cancer was 8 years (6–10.9). There were 583 patients (57.2%) who received mesna with intravenous CYC therapy. We observed similar incidence rate for hemorrhagic cystitis in both patient groups concomitantly treated with or without mesna [9/583 (1.5%) vs 8/425 (1.8%) respectively, p = 0.08]. Cumulative CYC dose (HR for 10-g increments 1.24, p < 0.001) was associated with hemorrhagic cystitis.Conclusion. Cumulative dose was the only risk factor for hemorrhagic cystitis in patients treated with CYC. No proof was obtained for the uroprotective effect of mesna in our cohort. ER -